Senior Citizen Obesity Counseling Proven Effective But Under-used

By Kathy Hubbard
A little over a year ago I wrote about the Medicare funded weight-loss counseling program called Intensive Behavior Therapy (IBT). At that time, almost no one knew about it. So I was excited when I got an update from registered dietician, Mary Kaiser who administers the program at Bonner General Health.
“Can we ‘toot our horn’ about our weight loss program?” Kaiser wrote. “I thought it might generate more business if people knew about our success.”
And success it is! There are currently 14 seniors enrolled in the program who have cumulatively lost 281.5 pounds. That’s an average of over 20 pounds per person over a roughly 21 week period.
The success is obviously for those who participated, but let’s take a look at who didn’t. The Census Bureau says that there are 41,585 people in the county, of those, 20.5 percent are over 65 years of age. The Centers for Disease Control and Prevention states that in the Medicare population, over 30 percent of men and women are obese. That means that there are roughly 2,550 people in Bonner County who fit into that mold. And, only 14 took advantage of the IBT program that costs them nothing?
Well, it does take a commitment and some lifestyle changes, but wouldn’t it be worth it to prevent cardiovascular disease, musculoskeletal conditions and diabetes? You know that obesity and smoking are the two leading causes of preventable death in the United States. So, maybe it’s time to take control of your health.
A brochure from Medicare states, “Medicare covers IBT for obesity defined as a body mass index (BMI) of 30 kilograms per meter squared, for the prevention or early detection of illness or disability.
I’ll stop right here to tell you that to find out your BMI, Google “BMI calculator” and put in your height and weight and it will figure it out for you. Usually your primary healthcare provider will also provide you with your BMI. He or she will also give you the needed referral to the IBT program.
“The focus is on behavior, it’s not a diet plan,” Kaiser said. “The patient must have the motivation to make some changes. The first four visits are weekly, and then visits are every two weeks until six months. In order to qualify for continuing the program the patient must have lost at least 6.6 pounds in the first 6 months, and then visits are monthly for a year.”
The Medicare brochure says that the counseling must be consistent with the 5As approach adopted by the U.S. Preventive Services Task Force. They are: 1. Assess health risks and factors affecting choice of behavior. 2. Advise the patient regarding personal health harms and benefits. 3. Agree to appropriate treatment goals and methods based on the beneficiary’s interest in and willingness to change the behavior. 4. Assist the patient in achieving agreed-upon goals by acquiring the skills, confidence and social or environmental supports for behavior change supplemented with adjunctive medical treatments when appropriate; and 5. Arrange for ongoing assistance and support and to adjust to the treatment plan as needed, including referral to more intensive or specialized treatment.
Let’s not kid ourselves, you know if you’re overweight. You also know that there are programs that you can do to overcome the fact that as we grow older we lose lean body mass and replace it with fat. But, that’s not irreversible. Even people in their 80s and 90s can show an increase in muscle tissue by starting a walking, running or weight-lifting regime. Really.
Step one is to see your primary healthcare provider for a complete work up. Then, be sure to ask for a referral to Bonner General Health for Intensive Behavioral Therapy. That’s just two simple baby steps you can take to live a longer, healthier life.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 264-4029 or [email protected].